The epidemic characteristics of differentiated thyroid cancer(DTC)are changing, thyrotropin(TSH)suppressive therapy is also improving in recent years. The risks of recurrence and the death of patients, as well as the adverse effects of levothyroxine sodium treatment should be fully considered during thyroid hormone administration for patients of DTC. Hence, the degree of TSH suppression should be individualized in patients with DTC.

T),resulting in His to Leu(CAT→CTT) substituted at codon 435(H435L).No mutation was identified in the patient's parents.HT occurred in the patient during following-up.Conclusion H435L mutation in exon 10 of TR? gene leads to resistance to thyroid hormone.Meanwhile,consistent RTH might lead to HT.

OBJECTIVE:To explore the role of clinical evidence-based pharmacy in anticoagulant treatment strategies during continuous renal replacement therapy (CRRT). METHODS:Taking a thrombocytopenia patient of anticoagulant treatment during CRRT for instance,clinical pharmacists analyzed the evidence of taken argatroban anticoagulant therapy during CRRT for high risk blooding and thrombocytopenia patients based on evidence-based pharmacy combined with clinical data,monitored the efficacy and safety and evaluated the treatment process. RESULTS:Totally five literature about anticoagulant treatment strategies during CRRT for high risk blooding and thrombocytopenia patients were obtained,including one systematic review,one RCT and three cohort studies. Based on the above evidences,good results were achieved in the clinical practice of this patient,no thrombotic or hemor-rhagic complications occurred in this patient,platelet count and coagulation indicators of patients also improved. CONCLUSIONS:Evidence-based pharmacy plays an important role in anticoagulant treatment strategies during CRRT.

Child, Preschool ; Diagnosis, Differential ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Hysteroscopy ; Pediatrics ; Puberty, Precocious ; diagnosis ; therapy ; Uterine Hemorrhage ; diagnosis ; etiology ; therapy ; Vaginal Diseases ; diagnosis ; etiology ; therapy

The present study identified the properties of porins in the outer membrane in Pseudomonas aeruginosa,and showed the role of outer membrane in determining imipenem diffusion in Pseudomonas aeruginosa. The molecular weight of the major outer membrane protein was analyzed by SDS-PAGE. The purification of the porins in Pseudomonas aeruginosa was achieved by DEAE ion - exchange HPLC. The purified outer membrane proteins were reconstituted with phosphatidylcholine and dicetylphosphate into membrane vesicles, and were tested by the liposomes swelling method for the diffusion of imipenem. The permeability assay showed that OprC (70 kD), OprD2 (46kD), and OprE(43 kD) were the channel- forming proteins. But only OprD2 was thought to be the likely route of imipenem diffusion.

OBJECTIVEThis research aimed to study the inhibitory effect of xylitol on the growth and acid production of Actinomyces viscosus (A. viscosus).

METHODSWe cultivated A. viscosus in anaerobic conditions with different concentrations (128, 64, 32, 16, 8, and 4 g x L(-1)) of xylitol brain heart infusion liquid medium and determined the minimum inhibitory concentration (MIC). Subsequently, we measured the pH value of the control group, as well as those of 1/2, 1/4, 1/8 MIC, and MIC concentration groups at 1.5, 3, 6, 12, 24, and 48 h. The Delta pH and OD550 at 2, 4, 6, 8, 10, and 12 h were calculated. We discovered that the minimum xylitol concentrations suppressed 50% and 90% A. viscosus biofilm formation (i.e., MBIC50 and MBIC90). SPSS 19.0 was used to analyze the collected data, and conclusions were drawn afterward.

RESULTSXylitol inhibited the growth ofA. viscosus at MIC of 64 g x L(-1). After 12 h, the differences of pH value among groups were all statistically significant (P < 0.05), and Delta pH increased when the MIC concentration decreased. Except for the 1/2 MIC and MIC groups, the differences of OD550 among groups had no statistical significance (P>0.05), and OD550 also increased when the MIC concentration decreased. These results imply that the ability ofA. viscosus to grow and produce acid in 1/2 MIC and MIC conditions will be reduced with the increase in xylitol concentration. The value of MIBC50 was 64 g x L(-1), whereas the value of MIBC90 was 128 g x L(-1). This finding indicates that the xylitol medium can restrict A. viscosus biofilm formation.

CONCLUSIONXylitolcan effectively inhibit the growth, adhesion, and acid production ofA. viscosus, protecting teeth from cariogenic bacteria and preventing caries to a certain extent.

Objectives:To study the ultrasonogram, diagnosis and significance of testicular microlithiasis (TM). Methods:The clinical data and ultrasonographic outcomes of 97 patients with the genital system diseases were retrospectively analyzed. Results:Five patients with TM were found, and the prevalence of TM is 5.2%. of 5 cases, 2 cases were associated with infertility, 1 cases with orchitis,1 case with seminoma, and 1 case with mature teratoma. Three cases with varicocele,2 cases with atrophic testis, 1 case with hydrocele and 1 case with spermatocele, were found out with the use of a high frequency transducer. The sonographic appearance of TM is multiple tiny(1-3 mm),no acoustic shadowing hyperechoic foci that are randomly scattered throughout the testicular parenchyma. Conclusions:Testicular microlithiasis has been associated with a variety of clinical entities, and it is an uncommon condition in which calcified concretions fill the lumen of seminiferous tubule, commonly diagnosed by high frequency (5～10 MHz ) testicular ultrasound. The accepted standard of TM is multiple small nonshadowing hyperechoic foci up to 3 mm in size, with five or more evident on a single sonogram.

Deep venous thrombosis (DVT) is initiated intraoperatively and may display symptoms postopera- tively following total hip or total knee arthroplasties. Pulmonary embolism (PE) and DVT cause morbidity and mortality. It has been established that patients who undergo a major lower-extremity joint replacement should receive prophylaxis due to the increased risk of DVT. Despite use of thrombo-prophylaxis, elective replacement surgery carries a high risk of venous thromboembolic complications. The early detection of DVT and treatment with systemic anticoagulation to pre- vent DVT are essential in the management of patients undergoing total joint arthroplasty. Extended medical throm- bo-prophylaxis is indicated for some high-risk patients. Routine postoperative duplex surveillance for DVT may be clinically useful. In the early post-operative phase, combined prophylaxis such as low-molecular-weight heparins and mechanical methods may be more effective than single intervention measures. However, the efficacy and safety of an- ticoagulation therapy, using various medicines administered after total arthroplasty of large joints are still undetermined and controversial.We should also be alert to the frequency and extent of postoperative hematomas. There are still many uncertainties in treatments to prevent DVT in terms of safety and cost-effectiveness. Therefore, prospective, ran- domised, controlled and multicenter studies may be necessary to obtain valuable information according to evidence based medicine.

Osteoclasts are derived from pluripotent stem cells in bone marrow and spleen.They play a critical role in inflammation-induced bone loss and joint destruction because in the absence of them,bone de- struction does not occur even when inflammation exists.Synovioblasts in an inflamed joint can secrete numerous inflammatory factors,including tumor necrosis factor alpha(TNF-?)and interleukin-1(IL-1)which not only induce inflammatory reactions but also elevate osteoclast formation and function indirectly or directly through promoting RANKL expression.In this wdy the inflammatory reactions are associated with bone loss and destruction. In this article,we focus on the recent progress in study of TNF-?,IL-1 and osteoclast-target therapies in management of osteoclast-mediated inflammatory bone loss.TNF-?promotes differentiation of osteoclast precursor cells in the peripheral blood and spleen,which causes a marked increase in mature osteoclasts in a diseased joint.However, IL-I supports osteoblast survival and regulates the recombination of osteoclast cytoskeleton,which further stimulates bone resorption.Since osteoclast-target therapies may inhibit osteoclast formation and function,they are becoming more and more important for inflammation-induced bone loss and joint destruction.

Objective To investigate whether the killer cell immunoglobulin like receptor (KIR) gene polymorphisms are associated with seronegative spondylarthropathies.Methods All 197 HLA B27 positive patients with seronegative spondyloarthro pathies (SpA) and 83 randomly ethnically matched healthy controls were enrolled to detect the KIR genotype using PCR SSP in Shanghai area.Results The KIR3DL1 gene frequency was significantly lower in the patient group (0 763) than in the control group (1 00) (RR=0 76, P =0 003).Meanwhile,the gene frequencies of two pseudogenes (KIR2DP1,KIR3DP1) were significantly higher in SpA group than in healthy control group (RR=1 1, P =0 004).Conclusion There may be a negative association between pathogenesis of SpA and KIR3DL1 gene.The function of KIR3DL1 molecule should be investigated deeply.